Provider Demographics
NPI:1265622914
Name:PEREIRA AND ASSOCIATES PSC
Entity type:Organization
Organization Name:PEREIRA AND ASSOCIATES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEREIRA-RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-565-8089
Mailing Address - Street 1:PO BOX 1902
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-1902
Mailing Address - Country:US
Mailing Address - Phone:787-768-3500
Mailing Address - Fax:
Practice Address - Street 1:BH12 CALLE 110
Practice Address - Street 2:VALLE ARRIBA HEIGHTS
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-3309
Practice Address - Country:US
Practice Address - Phone:787-757-5665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2639122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2639Medicare UPIN